Pregnancy and Kidney Disease
For a patient with chronic kidney disease,
questions about sexuality are often intertwined with questions
about pregnancy.
Can a woman who is on dialysis have a
child?
Usually not. Most female dialysis patients
do not have regular periods. The use of erythropoietin (EPO) has
improved some women's overall health, which can result in a
greater chance of pregnancy. If a patient becomes pregnant, she
usually has a miscarriage. Only rarely has a dialysis patient
been able to have a baby, and then only after increasing
treatments, changes in diet and medications, and more frequent
doctor visits. Pregnancy adds stress to the healthy body and can
put the dialysis patient and the unborn child at greater risk.
Being unable to have a baby can cause feelings of loss. Since
people in our society expect married couples to have children, a
childless woman may question her role. She may feel incomplete
or unfulfilled in her role as a woman, which may lead to feeling
negative about herself and her sexuality. As a way of coping,
she should talk openly about her feelings and needs with her
partner and/or health care staff. Other options, such as
adoption or becoming a foster parent, may also be available.
Is it possible for a man who is on
dialysis to father a child?
Yes. Men who are on dialysis or who have
received a kidney transplant can father children. A couple
should seek professional help if they have tried for at least a
year to have a child without success. A man can have a routine
fertility checkup.
Is becoming pregnant easier for a kidney
transplant recipient than for a dialysis patient?
Yes. A woman who has had a kidney
transplant usually has more regular periods and better general
health. Therefore, it is easier for her to get pregnant and have
a child. However, pregnancy is not recommended for at least one
year after the transplant, even with stable kidney function. In
some cases, pregnancy is not recommended because of risk to the
mother's life or possible loss of the transplant.
Can medicines taken by transplant
patients harm an unborn child?
The amount of anti-rejection medicines is
important. In the early period after a transplant, patients are
on higher doses of these medicines. Once the medicines are
reduced to maintenance levels, they do not seem to have negative
effects on a developing baby. However, long-term side effects
are still unknown. A woman transplant patient who is considering
pregnancy should discuss any possible risks with her doctor.
What kind of birth control is recommended
for kidney patients?
Dialysis patients who have periods or who
could become pregnant should use birth control to guard against
pregnancy. The doctor can recommend the type of birth control
that should be used. Generally, women who have high blood
pressure should not use the pill since it can raise blood
pressure. Transplant patients should not use an IUD. These
patients are more likely to get an infection from an IUD because
the anti-rejection drugs they must take also lower the body's
ability to fight infection. The diaphragm, sponge and condom are
good means of birth control, especially when used with
spermicidal creams, foams or jellies.
See also in this A-Z guide:
- Detecting Kidney and Urinary Tract
Abnormalities Before Birth
- Coping Effectively: A Guide for
Patients and their Families
- Sexuality and Chronic Kidney Disease
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